Bjerg-Bäcklund A, Perzanowski M S, Platts-Mills T, Sandström T, Lundbäck B, Rönmark E
The OLIN Studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden.
Allergy. 2006 May;61(5):549-55. doi: 10.1111/j.1398-9995.2006.01027.x.
Childhood is the most important time for asthma development. The aims of this study were to study changes in prevalence of asthma and wheeze, remission of asthma and changes in risk factor pattern from age 7-8 to age 11-12 in a cohort of school children.
In 1996, 3525 children aged 7-8 years in northern Sweden were invited to participate in a parental expanded ISAAC questionnaire survey. The cohort has been followed prospectively with yearly follow-ups to age 11-12, with a 97% yearly response rate. Skin prick tests were conducted at age 7-8 and 11-12.
The prevalence of physician-diagnosed asthma increased from 5.7% at age 7-8 to 7.7% at age 11-12. Life-time prevalence of wheeze was 34.7% at age 11-12. The remission of asthma was 10% yearly and inversely related to allergic sensitization. Relapses were common, and remission persisting throughout the observation period was 5% yearly. Allergic sensitization was associated with current asthma at age 7-8 [adjusted odds ratio (OR) 4.9 (95% confidence interval (CI) 3.3-7.3)] and when the children were 4 years older [OR 5.6 (3.9-8.2)]. A family history of asthma was associated with current asthma at age 7-8 [OR 3.0 (2.1-4.5)] and 11-12 (OR 2.8 [2.0-3.9]). Ever having lived with a cat was significantly negatively associated with current asthma.
The prevalence of asthma increased continuously during the primary school ages. Among several significant risk factors, allergic sensitization and a family history of asthma were the most important. With increasing age many known risk factors lost significance. Remission was inversely related to allergic sensitization.
儿童期是哮喘发病的最重要时期。本研究旨在调查一群学龄儿童从7至8岁到11至12岁期间哮喘和喘息患病率的变化、哮喘缓解情况以及危险因素模式的变化。
1996年，瑞典北部3525名7至8岁儿童受邀参与一项家长扩展版国际哮喘及变应性疾病研究（ISAAC）问卷调查。该队列自7至8岁起每年进行前瞻性随访直至11至12岁，年应答率为97%。在7至8岁和11至12岁时进行皮肤点刺试验。
医生诊断的哮喘患病率从7至8岁时的5.7%增至11至12岁时的7.7%。11至12岁时喘息的终生患病率为34.7%。哮喘的缓解率为每年10%，且与过敏致敏呈负相关。复发很常见，在整个观察期持续缓解的比例为每年5%。过敏致敏与7至8岁时的现患哮喘相关[校正比值比（OR）4.9（95%置信区间（CI）3.3 - 7.3）]，在儿童4年后也是如此[OR 5.6（3.9 - 8.2）]。哮喘家族史与7至8岁时的现患哮喘相关[OR 3.0（2.1 - 4.5）]以及11至12岁时相关[OR 2.8（2.0 - 3.9）]。曾与猫一起生活与现患哮喘显著负相关。
小学年龄段哮喘患病率持续上升。在多个重要危险因素中，过敏致敏和哮喘家族史最为重要。随着年龄增长，许多已知危险因素失去意义。缓解与过敏致敏呈负相关。
